JONATHAN ALCANTAR-HEREDIA, MD — NPI 1205401189 (Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) in DUARTE, CA)

CMS-1500 Box 24J / 33a • NPI

1205401189

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208800000X (CMS 34)

Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)

Box 32 Service Location & ZIP+4

1500 DUARTE RD, DUARTE, CA, 91010-3012

✓ 9-Digit EDI 837 ZIP+4 (91010-3012)

Practice Phone & Referral Fax

(800) 826-4673

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1205401189 (JONATHAN ALCANTAR-HEREDIA, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1205401189` (NPI-1 Individual Practitioner)
Provider / Legal Name	JONATHAN ALCANTAR-HEREDIA, MD
Plain-English Specialty	Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) NUCC Code: `208800000X` (Urology)
Certifying / Licensing Body	American Board of Urology (ABU)
Practice Location Address	1500 DUARTE RD, DUARTE, CA, 91010-3012
Practice Telephone / Fax	Tel: (800) 826-4673
Administrative Mailing Address	PO BOX 512185, LOS ANGELES, CA, 90051-0185
Enumeration & Last Sync	Enumerated: 2021-05-24 \| CMS Record Updated: 2026-06-03

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1500 DUARTE RD, DUARTE, CA, 91010-3012

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Plain-English Taxonomy & CMS Crosswalk (208800000X)

What Does Taxonomy Code 208800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208800000X translates to:
"Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 34 (Physician/Urology)
Certifying / Accrediting Authority: American Board of Urology (ABU)
Clinical Scope: Kidney stones causing flank pain, blood in urine (hematuria), recurrent urinary tract infections (UTIs), prostate enlargement, or urinary incontinence.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JONATHAN ALCANTAR-HEREDIA, MD)

Typical CPT / Diagnostic Procedures:

Diagnostic Cystourethroscopy (CPT 52000) & Urodynamic Flow Studies
Ureteroscopy with Holmium Laser Lithotripsy for Kidney Stones (CPT 52356)
Extracorporeal Shock Wave Lithotripsy (ESWL — CPT 50590)
Prostate Specific Antigen (PSA) Screening & Ultrasound-Guided Biopsy

Common Therapeutic Classes:

Alpha-Blockers (Tamsulosin, Alfuzosin) for BPH & Ureteral Stone Passage
5-Alpha Reductase Inhibitors (Finasteride, Dutasteride)
Targeted Urinary Antimicrobials (Nitrofurantoin, Fosfomycin, Ciprofloxacin, Septra)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208800000X` — Urology Plain English: Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)	State: CA \| License: `A204606` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JONATHAN ALCANTAR-HEREDIA, MD (NPI #1205401189)